Electrical Dry Needling Plus Corticosteroid Injection for Osteoarthritis of the Knee: A Randomized Controlled Trial |
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| Institution: | 1. College of Anesthesiology, Xuzhou Medical University, Xuzhou City, Jiangsu Province;2. Department of Pain Treatment, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, China;1. Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City, KS;2. Illinois Multiple Sclerosis Research Collaborative, Interdisciplinary Health Science Institute, University of Illinois at Urbana-Champaign, Urbana, IL;3. Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel;4. Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel;5. Department of Neurology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;6. Neuroimmunology and Multiple Sclerosis Unit of the Neurology Division, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel;7. NeuroCure, Charité–Universitaetsmedizin Berlin, Berlin, Germany;8. Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité–Universitaetsmedizin Berlin, Berlin, Germany;9. Department of Neurology, Charité–Universitätsmedizin Berlin, Berlin, Germany;10. Department of Neurology, School of Medicine, University of Kansas Medical Center, Kansas City, KS;11. Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;12. Rush Alzheimer''s Disease Center and Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL;1. Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan;2. Department of Rehabilitation Medicine, Kyorin University School of Medicine, Tokyo, Japan;3. Department of Rehabilitation Medicine, National Hospital Organization Saitama Hospital, Saitama, Japan;4. Brain Attack Center Ota Memorial Hospital, Hiroshima, Japan;5. Department of Rehabilitation Medicine, Kawasaki Municipal Hospital, Kanagawa, Japan;6. Department of Rehabilitation Medicine, Saiseikai Yokohama Tobu Hospital, Kanagawa, Japan;1. School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA;2. Duke University School of Medicine, Durham, NC;3. Department of Neurology, Wake Forest Baptist Health, Medical Center Blvd, Winston-Salem, NC;4. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC;5. Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY;6. Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC;1. Kennedy Krieger Institute, Baltimore, Maryland;2. Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland;3. Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland;4. Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland;5. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland;6. Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom;3. Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine and Science, Rochester, MN;1. Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI;2. Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Charlestown, MA;3. Massachusetts General Hospital, Boston, Massachusetts;4. Brigham and Women''s Hospital, Boston, MA;5. Department of Health Care Policy, Harvard Medical School, Boston, MA |
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| Abstract: | ObjectiveTo investigate the effects of electrical dry needling (DN) plus corticosteroid injection (CSI) on pain, physical function, and global change in patients with osteoarthritis of the knee (KOA).DesignA prospective, single-blinded, randomized controlled trial.SettingPain treatment clinic.ParticipantsSixty patients with KOA were randomly assigned to the electrical dry needling plus corticosteroid injection (electrical-DN+CSI) group or CSI group.InterventionsThe CSI group received glucocorticoid injection only once during the trial, and the electrical-DN+CSI group received glucocorticoid injection combined with 4 sessions of electrical-DN.Main Outcomes MeasuresThe primary outcome was the numerical rating scale at 3 months. The secondary outcomes were the Western Ontario and McMaster Universities Osteoarthritis Index, the time to complete the Timed Up and Go test, and the score of the global rating of change scale at 3 months. A generalized linear mixed-effects model was used to analyze the repeated measurement data.ResultsBaseline characteristics and measurements were similar in the 2 groups. The group by time interaction effect was significant for all variables (P<.05). The electrical-DN+CSI group obtained a more significant reduction in pain intensity and more significant improvement in dysfunction than the CSI group at 3 months (P<.05). The median global rating of change score for the CSI group was +3 (somewhat better), and that for the electrical-DN+CSI group was +4 (moderately better).ConclusionElectrical-DN therapy at myofascial trigger points combined with CSI is more effective at alleviating pain, improving dysfunction, and creating global change than CSI alone for patients with KOA. Electrical-DN may be an essential part of treatment for KOA rehabilitation. |
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